Dr Jerry Alvin Dearth, MD is a medicare enrolled "Family Medicine" physician in Grabill, Indiana. His current practice location is
13410 Main St, Box 340, Grabill, Indiana. You can reach out to his office (for appointments etc.) via phone at
(260) 422-2481.
Dr Jerry Alvin Dearth is licensed to practice in Indiana (license number 01029438A) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1588779375.
Physician's Profile
| Full Name | Dr Jerry Alvin Dearth |
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| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 13410 Main St, Grabill, Indiana |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1588779375
- Provider Enumeration Date: 08/20/2006
- Last Update Date: 10/11/2022
Medicare PECOS Information:
- PECOS PAC ID: 4789682535
- Enrollment ID: I20090105000547
Medical Identifiers
Medical identifiers for Dr Jerry Alvin Dearth such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1588779375 | NPI | - | NPPES |
| 100055390 | Medicaid | IN | |
| 000000595570 | Other | IN | ANTHEM |
| P00698419 | Other | IN | RAILROAD MEDICARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207Q00000X | Family Medicine | 01029438A (Indiana) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jerry Alvin Dearth allows following entities to bill medicare on his behalf.
| Entity Name | Parkview Health System Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1932130952 PECOS PAC ID: 2163336967 Enrollment ID: O20031117000288 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jerry Alvin Dearth is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Dr Jerry Alvin Dearth, MD 11109 Parkview Plaza Dr # 117, Fort Wayne, IN 46845-1701 Ph: () - | Dr Jerry Alvin Dearth, MD 13410 Main St, Box 340, Grabill, IN 46741-2001 Ph: (260) 422-2481 |
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